| Autor: |
Kinoshita, Akitoshi, Miyachi, Hayato, Matsushita, Hiromichi, Yabe, Miharu, Taki, Tomohiko, Watanabe, Tomoyuki, Saito, Akiko M., Tomizawa, Daisuke, Taga, Takashi, Takahashi, Hiroyuki, Matsuo, Hidemasa, Kodama, Kumi, Ohki, Kentaro, Hayashi, Yasuhide, Tawa, Akio, Horibe, Keizo, Adachi, Souichi |
| Předmět: |
|
| Zdroj: |
British Journal of Haematology; Oct2014, Vol. 167 Issue 1, p80-86, 7p, 2 Charts, 1 Graph |
| Abstrakt: |
The clinical characteristics and prognostic relevance of acute myeloid leukaemia ( AML) with myelodysplastic features remains to be clarified in children. We prospectively examined 443 newly diagnosed patients in a multicentre clinical trial for paediatric de novo AML, and found ' AML with myelodysplasia-related changes' ( AML- MRC) according to the 2008 World Health Organization classification in 93 (21·0%), in whom 59 were diagnosed from myelodysplasia-related cytogenetics alone, 28 from multilineage dysplasia alone and six from a combination of both. Compared with 111 patients with ' AML, not otherwise specified' ( AML- NOS), patients with ' AML- MRC' presented at a younger age, with a lower white blood cell count, higher incidence of 20-30% bone marrow blasts, unfavourable cytogenetics and a lower frequency of Fms-like tyrosine kinase 3 internal tandem duplication ( FLT3- ITD), NPM1 and CEBPA mutations. Complete remission rate and 3-year probability of event-free survival were significantly worse in ' AML- MRC' patients (67·7 vs. 85·6%, P < 0·01, 37·1% vs. 53·8% , P = 0·02, respectively), but 3-year overall survival and relapse-free survival were comparable with ' AML- NOS' patients. By multivariate analysis, FLT3- ITD was solely associated with worse overall survival. These results support the distinctive features of the category ' AML- MRC' even in children. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
|
Plný text